*5.3.4 Antithrombotic/anticoagulant pharmacotherapy*

If there is no contraindication, in individuals with T2DM over the age of 50, at high/very high CV risk, in the presence of the family history of premature atherosclerotic disease, hypertension, dyslipidemia, smoking, chronic kidney disease, aspirin (75–100 mg/day) may be considered in primary prevention. Aspirin (75–162 mg/day), or clopidogrel (75 mg/day) are recommended for secondary prevention. Dual antiplatelet therapy (low-dose aspirin and P2Y12 inhibitors: ticagrelor, clopidogrel, prasugrel) is recommended after an acute coronary syndrome, for a period of one year, possibly with benefits and longer use [12, 19].

Rivaroxaban 2.5 mg administered twice daily in combination with 100 mg aspirin, in T2DM patients with stable atherosclerotic vascular disease, has been shown to significantly reduce the primary outcome of CV death, stroke, myocardial infarction and major adverse limb events including amputation, but with more major bleeding events than those assigned to aspirin alone [66, 67].
